sb/bv
Date : 26.0000

Name of the Patient : Abc Xyzeer Grlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzain.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with burning sensation and paresthesias since 2 months.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of water content of the D11-D12, L3-L4, L4-L5 and L5-S1 intervertebral discs.

A postero-central disc herniation is noted at the L5-S1 level with slight inferior migration of the disc fragment. Facetal hypertrophy is noted at this level. The right S1 nerve root appears to be of slightly larger calibre and is ? inflammed. There is also posterior displacement of the left S1 nerve root.

A posterior disc bulge with a right postero-lateral (foraminal) disc herniation is seen at the L4-L5 level with right neural foraminal narrowing. A posterior peridiscal osteophyte is also noted at this level. Slight facetal hypertrophy is also identified. There is resultant pinching of the foraminal portion of the right L4 nerve root.

A minimal posterior disc bulge is noted at the L3-L4 level.

A small right paracentral protruded disc is noted at the D11-D12 level. Facetal arthropathy is also noted at this level.

Anterior disc herniations are seen at the L3-L4 and L4-L5 levels.

A hemangioma with fat content is noted in the L3 vertebral body to the left of the midline.
....2/..







- 2 -


The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

16.0 mm at L1-L2

15.0 mm at L2-L3

13.0 mm at L3-L4

10.0 mm at L4-L5

10.0 mm at L5-S1.

IMPRESSION :

1. A postero-central disc herniation at the L5-S1 level with slight inferior migration of the disc fragment with indentation upon the S1 nerve roots with facetal hypertrophy at this level.

2. A posterior disc bulge with a right postero-lateral (foraminal) disc herniation at the L4-L5 level. Posterior peridiscal osteophyte and slight facetal hypertrophy is also identified at this level with resultant impingement on the right foraminal L4 nerve root.

3. A small right paracentral protruded disc at the D11-D12 level with facetal arthropathy at this level.

4. Lumbar canal stenosis at the L4-L5 and L5-S1 levels.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzumar Slmn / M / 15 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with swelling over the ankles and knee joints since 1 month.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is slight loss of water content of the L1-L2, L3-L4 and L5-S1 intervertebral discs.

A small posterior disc herniation is noted at the L4-L5 level.

A right postero-lateral (foraminal) disc herniation with peridiscal osteophytes is noted at the L3-L4 level with right neural foraminal narrowing. There is a posterior disc bulge at the L5-S1 level.

Far lateral (extraforaminal) disc bulges are seen at the L3-L4 level.

Hypertrophic facetal arthropathy is noted at the L5-S1 level on the right and bilaterally at the L3-L4 level.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.
...2/...








- 2 -

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

16.0 mm at L1-L2

16.0 mm at L2-L3

14.0 mm at L3-L4

10.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

1. A small posterior disc herniation at the L4-L5 level.

2. A right postero-lateral (foraminal) disc herniation with peridiscal
osteophytes at the L3-L4 level.

3. Hypertrophic facetal arthropathy at the L5-S1 level on the right and bilaterally at the L3-L4 level.

hs/sb
/6 Date : 00.00.00

Name of the Patient : Abc XyzNalmn / M / 72 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left sided headaches, intermittent weakness, paresthesias in the LUE and BLE and sudden onset of arrest of speech for 1-2 hours since 2 months.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

A well-defined, area which is near isointense to CSF on the T2 Weighted images is seen within the left lentiform nucleus and extends into the left corona radiata. This would represent a lacunar infarct. A smaller lacunar infarct is noted within the left occipital lobe and left centrum semiovale. There is ex-vacuo dilatation of the left lateral ventricle.

Posterior parietal periventricular white matter ischemic lesions are noted bilaterally.

There is marked prominence of the left Sylvian fissure and cerebral cortical spaces in the left temporal lobe which would suggest volume loss, probably the result of a previous vascular insult.

There is prominence of the right Sylvian fissure, cerebellar folia, cerebral cortical sulcal spaces and basal cisternal spaces. Also seen is mild fullness of the third and the right lateral ventricles.

There is no shift of the midline structures.

INTRACRANIAL MRA :

The calibre of the left internal carotid artery is seen to be slightly smaller from its origin as compared to the opposite side.
....2/.








- 2 -


A very small segment of the proximal portion of the M1 segment of the left middle cerebral artery is visualized. The rest of the left middle cerebral artery is not seen.

Attenuated flow signal is seen within the left vertebral artery, distally. This may represent retrograde flow as the rest of the left vertebral artery from its origin is not identified.

The left posterior cerebral artery is not well-visualized. The right posterior cerebral artery and the posterior communicating arteries are slightly prominent.

The anterior cerebral arteries, basilar artery, carotid bifurcation, the right internal carotid artery,
right vertebral artery and both common carotid arteries are unremarkable.

IMPRESSION :

The MRI/MRA features are suggestive of :

1. Lacunar infarcts within the left lentiform nucleus extending into the left corona radiata, the left occipital lobe and left centrum semiovale.

2. Marked prominence of the left Sylvian fissure and cerebral cortical sulcal spaces
in the left temporal lobe. This would represent volume loss, most likely the result of a previous vascular insult.

3. Non-visualization of the distal left middle cerebral and left vertebral arteries and the left posterior cerebral artery.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzBandalmn / M / 44 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of water content of the L3-L4 and L5-S1 intervertebral discs.

There are fairly large, posteriorly herniated discs at the L2-L3 and L5-S1 levels with thecal sac compression and canal stenosis. Inferior migration of the disc is seen at the L2-L3 level posterior to the L3 vertebra. Small posterior peridiscal osteophytes are also seen at the L2-L3 level.

A small posterior disc bulge is noted at the L4-L5 level with bilateral neural foraminal narrowing.

Facetal hypertrophy is noted in the lumbar region.

The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

The lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.
....2/.







- 2 -


The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

12.0 mm at L1-L2

8.0 mm at L2-L3

13.0 mm at L3-L4

11.0 mm at L4-L5

7.0 mm at L5-S1.

IMPRESSION :

1. Fairly large, posteriorly herniated discs at the L2-L3 and L5-S1 levels with canal stenosis.

2. A small posterior disc bulge at the L4-L5 level.

3. Facetal hypertrophy in the lumbar region.

4. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzdi.
Examination : M.R.I. of the Pelvis.

LINICAL PROFILE :

C/O backache radiating to the LLE since December 0000 which has increased since 2-3 days with fever.

EXAMINATION :

M.R.I of the pelvis was performed using the following parameters :

6 mm thick T1 Weighted and T2 Weighted (fat saturation) axial images.

6 mm thick T1 Weighted and STIR coronal images.

The lumbo-sacral spine was scanned with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Irregularly defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images are seen to involve the left sacral ala and the lower sacral bodies. This lesion is seen to occupy the spinal canal from the L5-S1 level downwards. Also seen is extension into the left paraspinal muscles from the L5 vertebral level downwards. There is extension of this pathologic process into the left piriformis muscle and left gluteal muscles with probable encasement of the left sciatic nerve. Also seen is probable involvement of the right coccygeus muscle and ischio femoral ligament on the left side. There is a well-defined lesion in the region of the right piriformis muscle which appears hypointense on the T1 Weighted images with a hyperintense rim and turns hyperintense on the T2 Weighted images with a hypointense rim and is most likely an abscess. There is also suspicious involvement of the right superior gemellus muscle.

Follicles are seen within both the ovaries.

The urinary bladder appears normal.
...2/.








- 2 -


The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis.

Screening of the lumbar spine shows no feature of note.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the sacrum and
the left piriformis muscle and left gluteus muscles as described. This most likely represents an infective process (? tuberculosis). A probable abscess is identified in the region of the left piriformis muscle.

The possibility of this being a neoplastic process is less likely.

Date : 00.00.00

Name of the Patient : Abc Xyzine Fernalmn / F / 68 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the left shoulder with numbness in BUE and BLE (left more than right) since 15 days and heaviness of the head with giddiness.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs. The lower cervical intervertebral discs are reduced in height.

Minimal posterior disc bulges with peridiscal osteophytes are noted at the C2-C3 and C3-C4 levels.

Postero-central protruded discs with peridiscal osteophytes are noted at the C4-C5, C5-C6 and C6-C7 levels.

The upper cervical vertebral bodies show spotty fatty marrow changes.

Anterior disc herniations with peridiscal osteophytes are noted in the mid-cervical region.

The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

Incidental note is made of an enlarged thyroid gland with multiple cystic lesions within. These appear hyperintense on all pulse sequences, ? colloid cysts. Resultant slight narrowing of the tracheal lumen is noted and retrosternal extension.
..2/..






- 2 -


IMPRESSION :

1. Postero-central protruded discs with peridiscal osteophytes at the C4-C5 and C5-C6 and C6-C7 levels.

2. An enlarged thyroid gland with retrosternal extension with multiple cystic lesions, ? colloid cysts.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzRanlmn / F / 65 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness in BLE since 15 days.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The L3 and L4 vertebral bodies and pedicles appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T1 Weighted images. The L3-L4 intervertebral disc is also involved and appears hyperintense on the T2 Weighted images.
There is breach in the inferior cortical endplate of the L3 and superior cortical endplate of L4.

There is seen a prevertebral, paravertebral and anterior epidural intermediate signal intensity lesion on the T1 Weighted images at the L3 and L4 vertebral levels which also appear hyperintense on the T2 Weighted images. Resultant slight compression of the thecal sac at the L3-L4 level and also encroachment into the right L3-L4 neural foramen is noted with encasement of the right L3 nerve root.

A posterior and left far lateral disc bulge is noted at the L5-S1 level with indentation on the extraforaminal segment of the left L5 nerve root.

A small posterior disc bulge is noted at the L4-L5 level. Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

The rest of the visualized lumbar vertebral bodies show fatty marrow changes suggesting osteoporosis. The rest of the lumbar intervertebral discs show loss of water content.

The conus medullaris terminates at the L2 level and the thecal sac terminates at the S1 level.
...2/..





- 2 -


The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

17.0 mm at L1-L2

16.0 mm at L2-L3

9.0 mm at L3-L4

13.0 mm at L4-L5

11.0 mm at L5-S1.

Incidentally noted is erosion of the left iliac crest with a soft tissue lesion in that region.

Screening T1 Weighted sagittal images of the dorsal spine reveal fatty marrow changes of the dorsal vertebrae suggesting osteoporotic changes.

IMPRESSION :

Altered signal of the L3 and L4 vertebral bodies and pedicles with involvement of the L3-L4 intervertebral disc most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesions at these levels most likely represents granulation tissue.

The possibility of a neoplasm like a round cell tumor is less likely.

Erosion of left iliac crest with a soft tissue lesion in that region may represent
another tuberculous focus.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzkar M. Glmn / M / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O radicular pain in the LUE with numbness, weak grip and wasting since 1 1/2 months.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs with reduction in height
of the C6-C7 intervertebral disc.

Small postero-central protruded discs are noted at the C2-C3, C3-C4 and C4-C5 levels.

Slight degenerative changes of the joint of Luschka at the C3-C4 level is noted.

Posterior peridiscal osteophytes are identified at the C6-C7 level with a posterior disc bulge.

Type II degenerative marrow changes are noted adjacent to the C6-C7 intervertebral disc.

The facet joints at the C5-C6 level on the right side show degenerative changes.

The rest of the cervical vertebral bodies show normal signal intensity. The rest of the joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The left vertebral artery appears hypoplastic and may be a normal variant.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

Small postero-central protruded discs at the C2-C3, C3-C4 and C4-C5 levels.

Date : 00.00.00

Name of the Patient : Abc Xyzsh B. Balmn / M / 13 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O low grade fever with altered behaviour intermittently since 00.00.00.
C/O seizures since 2-4 days.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma.

The hippocampal complex is unremarkable on either side.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

There is no area of abnormal enhancement within the brain parenchyma or the meninges, after contrast administration.

IMPRESSION :

No abnormality is detected within the brain on this study.

Date : 00.00.00

Name of the Patient : Abc Xyzen Jhalmn / F / 56 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the LLE with paresthesias since 5 months.
H/O being operated on the left side of the neck 5 years back.Exact details not available.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is slight forward placement of the C3 over the C4 vertebrae and retroplacement of the C5 over the C6 vertebrae.

Small posterior disc herniations are seen at the C3-C4, C4-C5, C5-C6 and C6-C7 levels with posterior peridiscal osteophytes and anterior indentation of the thecal sac. The cervical intervertebral discs show loss of water content.

The C3-C4, C4-C5 and C5-C6 facet joints show mild degenerative changes. Mild ligamentum flavum hypertrophy is seen at the C5-C6 level.

The upper cervical vertebrae show areas of fatty replacement of normal marrow.

The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.
...2/..









- 2 -

IMPRESSION :

1. Slight forward placement of the C3 over the C4 vertebrae and retroplacement of the C5 over the C6 vertebrae.

2. Small posterior disc herniations with posterior peridiscal osteophytes at the C3-C4, C4-C5, C5-C6 and C6-C7 levels.